Abstract
The acute respiratory distress syndrome (ARDS) continues as a contributor to the morbidity and mortality of patients in intensive care units throughout the world, imparting tremendous human and financial costs. During the last ten years there has been a decline in ARDS mortality without a clear explanation. The American-European Consensus Committee on ARDS was formed to re-evaluate the standards for the ICU care of patients with acute lung injury (ALI), with regard to ventilatory strategies, the more promising pharmacologic agents, and the definition and quantification of pathological features of ALI that require resolution. It was felt that the definition of strategies for the clinical design and coordination of studies between centers and continents was becoming increasingly important to facilitate the study of various new therapies for ARDS.
Article PDF
Similar content being viewed by others
References
Artigas A, Carlet J, Le Gall JR, Chas-tang C, Blanch L, Fernandez R. Clinical presentation, prognostic factors and outcome of ARDS in the European Collaborative Study (1985–1987). A preliminary report. In: Adult respiratory distress syndrome. Zapol, Lemaire Eds. New York: Marcel Dekker, 1991:37–64.
Milbergh JA, Daris DR, Steinberg KP, Hudson LD. Improved survival of patients with acute respiratory distress syndrome (ARDS): 1983–1993. JAMA 1995; 273:306–309.
Wheeler AP, Bernard GR, Rinaldo JE. Future clinical trials of pharmacological therapy of adult respiratory distress syndrome. In: Adult respiratory distress syndrome. Artigas A, Lemaire F, Suter PM, Zapol WM eds. Churchill Livingstone, London, 1991:499–507.
Bernard GR, Artigas A, Brigham KL et al. The American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994; 149:818–824.
Gattinoni L, Pelosi P. Crotti S. Valenza F. Effects of positive end expiratory pressure on regional distribution of tidal volume and recruitment in adult respiratory distress syndrome. Am J Respir Crit Care Med 1995; 151:1807–1814.
Marini JJ. Ventilating ARDS: Looking for Mr. Goodmode. Anesthesiology 1994; 80:972–975.
Pesenti A, Pelosi P. Rossi N. Virtuani A, Brazzi L, Rossi A. The effects of positive end-expiratory pressure on respiratory resistance in patients with the adult respiratory distress syndrome and in normal anesthetized subjects. Am Rev Respir Dis 1991; 144:101–107.
Bowton DL, Kong DL. High tidal volume ventilation produces increased lung water in oleic acid injured rabbit lungs. Crit Care Med 1989; 17:908–911.
Carlton DP, Cummings JJ, Scheerer RG, Poulain FR, Bland RD. Lung overexpansion increases pulmonary microvascular protein permeability in young lambs. J Appl Physiol 1990; 69:577–583.
Corbridge TC, Wood LDH, Crawford GP, Chudoba MJ, Yanos J. Sznajder Jl. Adverse effects of large tidal volumes and low PEEP in canine acid aspiration. Am Rev Respir Dis 1990;142:311–315.
Dreyfuss D, Basset G. Soler PS, Saumon G. Intermittent positive-pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats. Am Rev Respir Dis 1985;132:880–8843
Dreyfuss D, Soler P. Saumon G. Mechanical ventilation-induced pulmonary edema: nteraction with previous lung alterations. Am J Respir Crit Care Med 1995; 151:1568–1575.
Dreyfuss D, Saumon G. Role of tidal volume, FRC, and end-inspiratory volume in the development of pulmonary edema following mechanical ventilation. Am Rev Respir Dis 1993; 148:1194–1203.
Dreyfuss D, Saumon G. Barotrauma is volutrauma, but which volume is the one responsible? Intensive Care Medicine 1992; 18:139–141.
Dreyfuss D, Soler P. Basset G. Saumon G. High inflation pressure pulmonary edema. Respective effects of high airway pressure, High tidal volume, and positive end expiratory pressure. Am Rev Respir Dis 1988; 137:1159–1164.
Gammon RB, Shin MS, Buchalter SE. Pulmonary barotrauma in mechanical ventilation: Patterns and risk factors. Chest 1992;102:568–572.
Gammon RB, Shin MS, Groves RH, Hardin M, HSU C, Buchalter SE. Clinical risk factors for pulmonary barotrauma: a multivariate analysis. Am J Respir Crit Care Med 1995; 152:1235–1240.
Hernandez LA, Peevy KJ, Moise AA, Parker JC. Chest wall restriction limits high airway pressure induced lung injury in young rabbits. J Appl Physiol 1989; 66:2364–2368.
Kolobow T Moretti MP, Fumigalli R. et al. Severe impairment in lung function induced by high peak airway pressure during mechanical ventilation. Am Rev Respir Dis 1987; 135:312–315.
Tsuno K, Prato P. Kolobow T. Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol 1990;69:956–961.
Hernandez LA, Coker PJ, May S. Thompson AL, Parker JC. Mechanical ventilation increases microvascular permeability in oleic acid injured lungs. J Appl Physiol 1990; 69:2057–2061.
Hickling KG, Walsh J. Henderson S. Jackson R. Low mortality rate in adult respiratory distress syndrome using low volume, pressure limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med 1994; 22:1568–1578.
Marini JJ, Ravenscraft SA. Mean airway pressure: Physiological determinants and clinical importance. Part 1 & 2. Crit Care Med 1992; 20:1461–1472 and 20:1604–1616.
Rouby JJ, Lherm T. Martin de Lassale E, Poete P. Bodin L, Finet JF, Callard P. Histologic aspects of pulmonary barotrauma in critically ill patients with acute respiratory failure. Intensive Care Medicine 1993; 19:383–389.
Roupie E, Dambrosio M, Servillo G. Mentec H. el Altrous S. Beydon L, Brun-Buisson C, Lemaire F. Brochard L. Titration of tidal volume reduction and induced hypercapnia in adult respiratory distress syndrome (ARDS). Am J Respir Crit Care Med 1995; 152:128.
Bond DM, McAloon J. Froese AB. Sustained inflations improve respiratory compliance during high frequency oscillatory ventilation but not during large tidal volume positive pressure ventilation in rabbits. Crit Care Med 1994; 22:1269–1277.
Muscedere JG, Mullen JBM, Gan K, Bryan AC, Slutsky AS. Tidal volume at low airway pressures can augment lung injury. Am J Respir Crit Care Med 1994;149:1327–1334.
Pelosi P. D, Andrea L, Vitale G. Pesenti A, Gattinoni L. Vertical gradient of regional lung inflation in adult respiratory distress syndrome. Am J Respir Crit Care Med 1994; 149:8–13.
Gattinoni L, Pelosi P. Vitale G. Pesenti A, D, Andrea L, Mascheroni D. Body position changes redistribute lung computed tomographic density in patients with acute respiratory failure. Anesthesiology 1991; 74:15–23.
Pappert D, Rossaint R. Slama K, Gruning T. Falke K. Influence of positioning on ventilation-perfusion relationships in severe adult respiratory distress syndrome. Chest 1994; 106:1511–1516.
Albert RK. One good turn... Intensive Care Medicine 1994; 20:247–248.
Broccard A, Marini JJ. Effect of posture and position on the respiratory system. Yearbook of Intensive Care and Emergency Medicine, JL Vincent, ed. Springer-Verlag, New York. 1995 pp165–184.
Fu Z. Costello ML, Tsukimoto K, Prediletto R. Elliott AR, Mathieu-Costello O. West JB. High lung volume increases stress failure in pulmonary capillaries. J Appl Physiol 1992; 73:123–133.
Mathieu-Costello O. Willford CD, Fu Z. Garden RM, West JB. Pulmonary capillaries are more resistant to stress failure in dogs than in rabbits. J Appl Physiol 1995; 79:908–917.
Rossaint R. Falke K, Lopez F. et al. Inhaled nitric oxide for the adult respiratory distress syndrome. N Engl J Med 1993; 328:399–405.
Nahum A, Shapiro RS, Ravenscraft SA, Adams AB, Marini JJ. Efficacy of expiratory tracheal gas insufflation in a canine model of lung injury. Am J Respir Crit Care Med 1995; 152:489–495.
Ravenscraft SA, Burke WC, Nahum A, Adams AB, Nakos G. Marcy TW, Marini JJ. Tracheal gas insufflation augments C02 clearance during mechanical ventilation. Am Rev Respir Dis 1993;148:345–351.
Fuhrman BP, Paczan PR, DeFrancisis M. Perfluorocarbon-associated gas exchange. Crit Care Med 1991; 19:712–722.
Hirschl RB, Pranikoff T. Wise C, Overbeck MC, Gauger P. et al. Initial experience with partial liquid ventilation in adult patients with the acute respiratory distress syndrome. JAMA 1996; 275:383–390.
Hirschl RB, Tooley R. Parent AC, Johnson K, Bartlett RH. Improvement in gas exchange, pulmonary function, and lung injury with partial liquid ventilation: a study model in a setting of severe respiratory failure. Chest 1995;108:500–508.
Marini JJ. Down side up: A prone and partial liquid asset. Intensive Care Medicine 1995; 21:963–965.
Lewis JF, Jobe AH. Surfactant and the adult respiratory distress syndrome. Am Rev Respir Dis 1993; 147:218–233.
Pappert D, Busch T. Gerlach H. Lewandowski K, Rademacher P. Rossaint R. Aerosolized prostacyclin versus inhaled nitric oxide in children with severe acute respiratory distress syndrome. Anesthesiology 1995; 82:1507–1511.
Brunet F. D Jeanbourquin, M Monchi, JP Mira, L Fierobe et al. Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan? Am J Respir Crit Care Med 1995; 152:524–530.
Lachmann B. Open up the lung and keep the lung open. Intensive Care Med 1992; 18:319–321.
Ranieri VM, Mascia L, Fiore T. Bruno F. Brienza A, Giuliani R. Cardiorespiratory effects of positive end expiratory pressure during progressive tidal volume reduction (permissive hypercapnia) in patients with acute respiratory distress syndrome Anesthesiology 1995; 83:710–720.
Suter PM, Fairley HB, Isenberg MD: Effect of tidal volume and positive end-expiratory pressure on compliance during mechanical ventilation. Chest 1978; 73:158–162.
Feihl F. Perret C. Permissive hypercapnia. How permissive should we be? Am J Respir Crit Care Med. 1994; 150:1722–1737.
Kacmarek RM, Hickling KG. Permissive Hypercapnia. Respir Care 1993; 38:373–387.
Amato MBP, Barbas CSV, Medeiros DM, Schettino GDP, Filho GL, et al. Beneficial effects of the „open lung“ approach“ with low distending pressures in acute respiratory distress syndrome. Am J Respir Crit Care Med 1995; 152:1835–1846.
Morris AH, Wallace CJ, Menlove RL, Clemmer TP, Orme JF Jr., et al. Randomized clinical trial of pressure controlled inverse ratio ventilation and extracorporeal C02 removal for Adult respiratory distress syndrome. Am J Respir Crit Care Med 1994; 149:295–305.
Marcy TW, Marini JJ. Inverse ratio ventilation in ARDS: Rationale and implementation. Chest 1991;100:494–504.
Gluck E, Heard S. Patel C, Mohr J. Calkins J. Use of ultra high frequency ventilation in patients with ARD-S...A preliminary report. Chest 1993; 103:1413–1420.
Tuchschmidt J. Fried J. Astiz M et al. Elevation of cardiac output and oxygen delivery improves outcome in septic shock. Chest 1992; 102:216–220.
Gattinoni L, Brazzi L, Pelosi P. Latini R. Tognoni G. Pesenti A, Fumigalli R. A trial of goal-oriented hemodynamic therapy in critically ill patients. Sv02 Collaborative Group. N Engl J Med 1995; 333:1025–1032.
Schuster DP. Fluid management in ARDS: “keep them dry” or does it matter? Intensive Care Medicine 1995; 21:101–103.
Rinaldo JE, Christman JW: Mechanisms and mediators of the adult respiratory distress syndrome. Clin Chest Med 1990:11:621–632.
Brigham KL: Role of free radicals in lung injury. Chest 1986; 89:859–863.
Weiss SJ: Tissue destruction by neutrophils. N Engl J Med 1989; 320:365–376.
Tracey KJ, Cerami A. Tumor necrosis factor: an update and review of its biology. Crit Care Med 1993; 21:S415-S422.
Dhainaut JF, Mira JP, Fierobe L. Platelet activating factor pathophysiological changes and therapeutic implications in sepsis. In: Sepsis, Current perspectives in pathophysiology and therapy. Eds K Reinhart, K Eyrich, C Sprung. Springer Verlag, Berlin 1994; pp 382–390.
Christman JW, Wheeler AP, Bernard GR: Cytokines and sepsis: What are the therapeutic implications? J Crit Care 1991; 6:172–182.
Marks JD, Marks CB, Luce JM, et al: Plasma tumor necrosis factor in patients with septic shock: Mortality rate, incidence of adult respiratory distress syndrome, and effects of methylpred-nisolone administration. Am Rev Respir Dis 1990; 141:94–97.
Suter PM, Suter S, Girardin E, Roux-Lombard P, Grau GE, Dayer JM. High bronchoalveolar levels of tumor necrosis factor and its inhibitors, inter-leukin-1, interfon and elastase in patients with ARDS after trauma, shock or sepsis. Am Rev Respir Dis 145:1016–1022,1992.
Hyers TM, Tricomi SM, Dettenmeier PA, Fowler AA: Tumor necrosis factor levels in serum and bronchoalveolar lavage fluid of patients with the adult respiratory distress syndrome. Am Rev Respir Dis 1991; 144:268–271.
Pacht ER, Timerman AP, Lykens MG, Merola AJ: Deficiency of alveolar fluid glutathione in patients with sepsis and the adult respiratory distress syndrome. Chest 1991; 100:1397–1403.
Bernard, G.R., Swindell, B.B., Meredith, M.J., Carroll, F.E., Higgins, S.B. Glutathione (GSH) repletion by nacetylcysteine (NAC) in patients with the adult respiratory distress syndrome (ARDS). Am Rev Respir Dis 1989;139(4):221A.
Lee CT, Fein AM, Lippmann M, et al: Elastolytic activity of pulmonary lavage fluid from patients with adult respiratory-distress syndrome. N Engl J Med 1981; 304:192–196.
Christner P. Fein A, Goldberg S. et al: Collagenase in the lower respiratory tract of patients with adult respiratory distress syndrome. Am Rev Respir Dis 1985; 131:690–695.
Miller EJ, Cohen AB, Nagao S, Griffith D, Maunder RJ, Martin TR, Wie-ner-Kronish JP, Sticherling M, Christophers E, Matthay MA. Elevated levels of NAP-l/Interleukin-8 are present in the airspaces of patients with the adult respiratory distress syndrome and are associated with increased mortality. Am Rev Respir Dis 1992; 146:427–432.
Donnely SC, Haslett C, Dransfield I, Robertson CE, Carter DC, Ross JA, Grant IS, Tedder TF. Role of selecting in development of adult respiratory distress syndrome. Lancet 1994; 344:215–219.
Baughman RP, Gunther KL, Keeton DA, et al. Changes in the inflammatory response of the lung during acute respiratory distress syndrome: prognostic indicators. Am J Respir Crit Care Med 1996; 154:76–81
Zapol WM, Snider MT: Pulmonary hypertension in severe acute respiratory failure. N Engl J Med 1977; 296:476–480.
Zapol WM, Hurford WE. Inhaled nitric oxide in the adult respiratory distress syndrome and other lung diseases. New Horizons 1993; 1:638–650.
Spragg RG, Gilliard N. Richman P. et al. Acute effects of a single dose of porcine surfactant on patients with the adult respiratory distress syndrome. Chest 1994; 105:195–202.
MacIntyre NR, Coleman RE, Schuller FS et al. Efficiency of the delivery of aerosolized artificial surfactant to intubated patients with the adult respiratory distress syndrome. Am J Respir Crit Care Med 1994; 149:A125.
Anzueto A, Baughman RP, Guntupalli KK, Weg JG, Wiedemann HP, Artigas A, Lemaire F, Long W, Zaccardelli DS, Pattishall EN, for the Exosurf Acute Respiratory Distress Syndrome Sepsis Study Group. Aerosolized surfactant in adults with sepsis-induced acute respiratory distress syndrome. N Engl J Med 1996; 334:1417–21.
Shenai JP, Kennedy KA, Chytil F. Stahlman MT. Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia. J Ped 1987; 111:269–77.
Hogg JC: Morphologic features of the lung in the respiratory failure associated with hypovolemic and septic shock. Prog Cain Biol Res 1989; 308:27–35.
Snyder LS, Hertz MI, Harmon KR, Bitterman PB: Failure of lung repair following acute lung injury: Regulation of the fibroproliferative response (Part 1). Chest 1990; 98:733–738.
Snyder LS, Hertz MI, Harmon KR, Bitterman PB: Failure of lung repair following acute lung injury: Regulation of the fibroproliferative response (Part 2). Chest 1990; 98:989–993.
Gregory JJ, Gade JE, Hyers TM, Crim C, Hudson LD, Steinberg KP, Maunder RA, Sprag RG, Smith RM, Tierney DF, Gipe G, Longore WJ, Moxley ME. Survanta supplementation in patients with acute respiratory distress syndrome (ARDS). Am J Respir Crit Care Med 1994; 149:A567.
Bernard G, Plitman JD. The Pharmacology of the Acute Respiratory Distress Syndrome. In: Critical Care: State of the Art. Eds MM Parker, MJ Shapiro, DT Porembka. Society of Critical Care Medicine. 1994; pp 29–54.
Kollef MH, Schuster D. The acute respiratory distress syndrome. N Engl J Med 1995; 332:27–37.
Ziegler EJ, Fisher CJ, Sprung CL et al. Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. N Engl J Med 1991; 324:429–436.
Greenman, R.L., Schein, R.M.H., Martin, M. A., et al. A controlled clinical trial of murine monoclonal IGM antibody to endotoxin in the treatment of gram-negative sepsis. JAMA 1991; 266:1097–1102.
Luce JM Montgomery AB, Marks JD, et al: Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with sepsis. Am Rev Respir Dis 1988; 138:62–68.
Bernard GR, Luce JM Sprung CL, et al: High-dose corticosteroids in patients with the adult respiratory distress syndrome. N Engl J Med 1987; 317:1565–1570.
Schonfeld SA, Ploysongsang Y. DiLisio R. et al: Fat embolism prophylaxis with corticosteroids: prospective study in high-risk patients. Ann Intern Med 1983; 99:438–443.
Lindeque BGP, Schoeman HS, Dom-misse GF, et al: Fat embolism and the fat embolism syndrome: A double-blind therapeutic study. J Bone Joint Surg 1987; 69B:128–131.
Kallenbach J. Lewis M, Zaltzman M, Feldman C, et al: ‘Low-dose’ corticosteroid prophylaxis against fat embolism. J Trauma 1987; 27:1173–1176.
Masur, H., Meier, P., McCutchan, J. A., Bernard, G.R., et al. Consensus statement for use of corticosteroids as adjunctive therapy for Pneumocystis pneumonia in AIDS. New England Journal of Medicine, 1990; 323:1500–4.
Meduri GU, Chinn AS, Leeper KV, et al. Corticosteroid rescue treatment of progressive fibroproliferation in late ARDS. Chest 1994; 105:1516–27.
Meduri GU, Headley S, Golden E, et al. Methylpredinisolone Treatment (MPT) of Late ARDS. Am J Respir Crit Care Med 1997; 155:A391.
Bernard GR, Reines HD, Halushka PV, et al: Prostacyclin and thromboxane A2 formation is increased in human sepsis syndrome: Effects of cyclooxygenase inhibition. Am Rev Respir Dis 1991; 144:1095–1101.
Haupt M, Jastremski M, Clemmer T et al. Effect of ibuprofen in patients with severe sepsis: A randomized double-blind multi-center study. Crit Care Med 1991; 19:1339–1347.
Yu M, Tomasa G. A double-blind, prospective, randomized trial of ketocon-azole, a thromboxane synthetase inhibitor, in the prophylaxis of the adult respiratory distress syndrome. Crit Care Med 1993; 21:1635–1642.
Lanore JJ, Dhainhaut JF, Fisher CJ et al. Effects of an anti-TNF IgG monoclonal antibody on left ventricular performance in septic patients. Am Resp Rev Dis 1993; 147:A202.
Abraham E, Wunderink R, Silverman H, et al. Efficacy and safety of monoclonal antibody to human tumor necrosis factor-a in patients with sepsis syndrome. A randomized, controlled, double-blind, multicenter clinical trial. JAMA 1995; 273:934–941.
Fisher CJ, Dhainaut JFA, Opal SM, Pribble JP, Balk RA, Slotman GJ, Iberti TJ, Rackow EC, Shapiro MJ, Greenman RL, Reines D, Shelly MP, Thompson BW, La Brecque JF, Catalano MA, Knaus WA, Sadoff JC, for the phase III rhIL-1ra sepsis syndrome study group. Recombinant human in-terleukin 1. Receptor antagonist in the treatment of patients with sepsis syndrome JAMA 1994; 271:934–941.
Pinckard RN, McManus LM, Hanahan DJ: Chemistry and biology of acetyl glyceryl ether phosphorylcholine (platelet-activating factor). Adv Inflammation Res 1982; 4:147–180.
Ward A, Clissold SP: Pentoxifylline: A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy. Drugs 1987; 34:50–97.
Mandell G. ARDS, neutrophils and pentoxifylline. Am Resp Dis 1988; 138:1103–1105.
Farmer JC, Burkey TH, Kew RR and Webster RO. Concentration-dependent regulatory effects of prostaglandin El on human neutrophil function in vitro. Am Rev Respir Dis 1991; 144:593–599.
Holcroft JW, Vassar MJ, Weber CJ: Prostaglandin El and survival in patients with the adult respiratory distress syndrome: A prospective trial. Ann Surg 1986; 203:371–378.
Bone RC, Slotman G. Maunder R. et al: Randomized double-blind, multi-center study of prostaglandin El in patients with the adult respiratory distress syndrome. Chest 1989; 96:114–119.
Cross CE, Halliwell B. Borish ET, et al: Oxygen radicals and human disease. Ann Intern Med 1987; 107:526–545.
McQuire WW, Spragg RG, Cohen AB, Cochrane CG: Studies on the pathogenesis of the adult respiratory distress syndrome. J Clin Invest 1982; 69:543–553.
Bernard GR: N-acetylcysteine in experimental and clinical acute lung injury. Am J Med 1991; 91(Suppl3C):54S-59S.
Jepson S. Herlevsen P. Knudsen P. Bud Me, Klausen NO. Antioxidant treatment with N-acetylcysteine during adult respiratory distress syndrome: a prospective, randomized, placebo-controlled study. Crit Care Med 1992; 20:918–923.
Wolff HRD, Seegert HW. Experimental and clinical results in shock lung treatment with vitamin E. Ann New York Acad Sci 1982; 393:392–409.
Bernard GR, Dupont W, Edens T, et al. Antioxidants in the acute respiratory distress syndrome (ARDS). Am J Respir Crit Care Med 1994; 149(4):A241.
Suter PM, Domenighetti G. Schaller M-D, Laverriere M-C, Ritz R. Perret C. N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study. Chest 1994; 105:190–94.
Bernard, G.R., Wheeler, A.P., Arons, M.M., Morris, P.E., Paz, H.L., Russell, J. A., Wright, P.E. A Trial of Antioxidants N-Acetylcysteine and Procysteine in the Acute Respiratory Distress Syndrome. Chest, 112(1):164–172, 1997.
Ricou B, Nicod L, Welgus HG, et al. AJRCCM, Matrix metalloproteinases and TIMP in acute respiratory distress syndrome. 154(2 Pt l):346–52, 1996.
Wheeler AP, Carroll FE, Bernard GR. Radiographic issues in the adult respiratory distress syndrome. New Horizons 1993; 1:471–477.
Wortel CH, Doerschuk CM. Neutrophils and neutrophil-endothelial cell adhesion in adult respiratory distress syndrome. New Horizons 1993; 1:631–637.
Nelson S, Bagby GJ. Granulocyte colony-stimulating factor and modulation of inflammatory cells in sepsis. Clinics in Chest Medicine 1996; 17(2):319–32.
Gilliard N, Pappert D, Spraag RG. Fractal Analysis of Surfactant deposition in rabbit lungs. J Appl Physiol 1995; 78:862–866.
Brigham, KL, Canonico AE, Conary JT, et al. Potential for gene therapy in the treatment of sepsis. In: Sepsis: Current perspectives in pathophysiology and therapy, in the series: “Update in Intensive Care and Emergency Medicine.” K. Reinhart, K. Eyrick C. Sprung, Eds., Springer-Verlag, Berlin, 1994, pp. 528–535.
Hyers TM. Risk factors and outcome in ARDS. In 1994 Yearbook of intensive care and emergency medicine. Ed Vincent JL. Springer-Verlag, Berlin, Germany 1994, pp. 465–473.
Shoemaker WC, Appel PL, Krarn HB, Waxman K, Lee T-S. Prospective trial of supranorrnal values of survivors as therapeutic goals in high-risk surgical patients. Chest 1988;94:1176–1186.
Ronco JJ, Phang T. Walley KR, Wiggs B. Fenwick JC, Russell JA. Oxygen consumption is independent of changes in oxygen delivery in severe adult respiratory distress syndrome. Am Rev Respir Dis 1991;143:1267–1273.
Hayes MA, Timrnins AC, Yau EHS, Palazzo M, Hinds CJ, Watson D. Elevation of systemic oxygenation in the treatment of critically ill patients. N Engl J Med 1994, 330:1717–22.
Stelzer H. Hiesmayer M, Mayer N. Krafft P. Hammerle AF. The relationship between oxygen delivery and uptake in the critically ill: is there a critical or optimal value? Anaesthesia 1994, 49:229–36.
Gilbert EM, Haupt MT, Mandanas RY, Huaringa AJ, Carlson RW. The effect of fluid loading, blood transfusion, and catecholamine infusion on oxygen delivery and consumption in patients with sepsis. Am Rev Respir Dis 1986; 134:873–878.
Pool GV, Meredith JW, Penned T, Mil-lis SA. Comparison of colloid and crystalloids in resuscitation from hemorrhage shock. Surg Gynecol Obstet 1982; 154:577–586.
Ruokonen E, Takala J. Vusaro A. A effect of vasoactive treatment on the relationship between mixed venous and regional oxygen saturation. Crit Care Med 1991;19:1365–1369.
Chiolero R. Flatt J-P, Revelly J-P, Jequier E. Effects of catecholamine on oxygen consumption and oxygen delivery in critically ill patients. Chest 1991;100:1676–1684.
Pinsky MR, Matuschak GM. A unifying hypothesis of multiple systems organ failure: failure of host defense homeostasis. J Crit Care 1990;5:108–114.
Schuller D, Mitchell JP, Calandrino FS, Schuster DP. Fluid balance during pulmonary edema. Is fluid gain a marker or a cause of poor outcome? Chest 1991; 100:1068–1075.
Pulmonary Artery Catheter Consensus Conference: Consensus Statement. Pulmonary Artery Catheter Consensus Conference Participants (Dr. Bernard represented the American Thoracic Society) Crit Care Med 1997 25:910–925.
Fulkerson, W. J., Bernard, G.R. Right Heart Catheterization in Acute Respiratory Failure. New Horizons 1997. 5:239–243.
Cobb DK, High KP, Sawyer RG, Sable CA, Adams RB, Lindley DA, et al. A controlled trial of scheduled replacement of central venous and pulmonary-artery catheters. N Engl J Med 1992;327:1062–8.
Torres A, Serra-Battles J. Ros E, Piera C, Puig de la Bellacasa J. Cobos A, et al. Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position. Ann Intern Medicine 1992; 116:540–3.
Ledingham IMcA, Alcock SR, Eastway AT, et al. Triple regimen of selective decontamination of the digestive tract, systemic cefotamine, and microbiological surveillance for prevention of acquired infection in intensive care. Lancet 1988 April 9:785–9.
Vallés J, Artigas A, Rello J, et al. Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia. Ann Intern Med 1995; 122:179–186.
Chastre J. Fagon JY. Invasive diagnostic testing should be routinely used to manage ventilated patients with suspected pneumonia. Am J Respir Crit Care Med 1994; 150:570–4.
Niederman MS, Torres A, Summer W. Invasive diagnostic testing is not needed routinely to manage suspected ventilator-associated pneumonia. Am J Respir Crit Care Med 1994; 150:565–9.
Meduri GU, Chastre J. The standardization of bronchoscopic techniques for ventilator-associated pneumonia. Chest 1992;102:S575-S645.
Koretz RL. Feeding controversies. In: Nutrition in critical care. Ed Zaloga G. Mosby, Missouri, 1994; pp.283–96.
Round table conference on metabolic support of critically ill patients. Intensive Care Med 1994;20:298–99.
The veteran’s affairs total parenteral nutrition cooperative study group. Peri-operative total parenteral nutrition in surgical patients. N Engl J Med 1986; 70:180–182.
Moore FA, Feliciano DV, Andressy RJ, McArdle AH, Booth FV McL, Morgenstein-Wagner TB, Kellum JM Jr, Welling RE, Moore EE. Early enteral feeding, compared with parenteral reduces postoperative septic complications: the results of a meta-analysis. Ann Surg 1992; 216:172–183.
Duke GJ, Bersten AD. Dopamine and renal salvage in the critically ill patient. Anaesthesis & Intensive Care 1992; 20:277–87.
Aidinis SJ, Lafferty, Shapiro HM. Intracranial response to PEER Anesthesiology 1976; 45:1239–45.
Wheeler, AP. Analgesia, Sedation, and Therapeutic Paralysis in the Critically 111. Seminars in Respiratory and Critical Care Medicine 1997; 18:1:39-63.
Norton LC, Chulay M, Tyler M, Hoffman L, Elpern E, Larson J. et al. Common problems and state of the art in nursing care of the mechanically ventilated patient. Am Rev Respir Dis 1988;138:1055–6.
Prod’hom G. Leuenberger P. Koerfer J. Blum A, Chiolero R. Shaller MD, et al. Nosocomial pneumonia in mechanically ventilated patients receiving antacid, ranitidine, or sucralfate as prophylaxis for stress ulcer. A randomized controlled trial. Ann Intern Med 1994;120:653–62.
Lamy M, Fallat RJ, Koeniger E, et al. Pathologic features and mechanisms of hypoxemia in adult respiratory distress syndrome. Am Rev Respir Dis 1976; 114:267–84.
Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 1988; 138:720–723.
Rinaldo JE, Rogers, RM. Adult respiratory distress syndrome: changing concepts of lung injury and repair. N Engl J Med 1982; 306:900–909.
Brigham KL, & Meyrick B. Endotoxin and lung injury. Am Rev Respir Dis 1986; 133:913–927.
Matthay MA, Wiener-Kronish JP. Intact epithelial barrier function is critical for the resolution of alveolar edema in humans. Am Rev Respir Dis 1990; 142:1250–1257.
Staub NC, Hyde RW, Crandall E. Workshop on techniques to evaluate lung alveolar-microvascular injury. Am Rev Respir Dis 1990; 141:1071–1077.
Gregory TJ, Longmore WJ, Mosley MA et al. Surfactant chemical composition and biophysical activity in acute respiratory distress syndrome. J Clin Invest 1991; 88:1976–1981.
Hallman M, Spragg R, Harrell JH, Moser KM. Evidence of lung surfactant abnormality in respiratory failure. J Clin Invest 1982; 70:673–683.
Clark JG, Milberg JA, Steinberg KP, and Hudson LD. Type III procollagen peptide in adult respiratory distress syndrome. Ann Int Med 1995; 122; 17–23.
Bachofen M, Weibel ER. Alterations of the gas exchange apparatus in adult respiratory insufficiency associated with septicemia. Am Rev Respir Dis 1977; 116:589–615.
Fukuda Y, Ishizaki M, Masuda Y, Kimura G, Kawanami O, Masugi Y. the role of intraalveolar fibrosis in the process of pulmonary structural remodeling in patients with diffuse alveolar damage. Am J Path 1987; 126:171–182.
Matthay MA. Function of the alveolar epithelial barrier under pathological conditions. Chest 1994; 105:675–745.
Tomashefski JF Jr, Davies P, Boggis C, Greene R, Zapol WM, Reid L. The pulmonary vascular lesions of the adult respiratory distress syndrome. Am J Pathol 1983; 112:112–126.
Gattinoni L, Bombino M, Pelosi P, Lissoni A, Pesenti A, Fumagalli R, Tagliabuc M. Lung structure and function in different stages of severe adult respiratory distress syndrome. JAMA 1994; 271:1772–79.
Zapol Wm, Trelstad RL, Coffey JW, Tsai I, Salvador AR. Pulmonary fibrosis in severe acute respiratory failure. Am Rev Respir Dis 1979; 119:547–554.
Berthiaume Y, Albertine KH, Grady M, Fich G, Matthay MA. Protein clearance from the air spaces and lungs of unanesthetized sheep over 144 h. J Appl Physiol 1989; 67:1887–97.
Bertozzi P, Astedt B, Zenzius L, Lynch K, LeMaire F, Zapol W, and Chapman IJA Jr. Depressed bronchoalveolar urokinase activity in patients with adult respiratory distress syndrome. N Engl Med 1990; 322:890–897.
Idell S, James KK, Levin EG, Schwartz BS, Manchanda N, Maunder RJ, Martin TR, McLarty J, Fair DS. Local Abnormalities in coagulation and fibrinolytic pathways predispose to alveolar fibrin deposition. J Clin Invest 1989; 84:695–705.
Pratt PC, Vollmer RT, Shelburne JD, Crapo JD. Pulmonary morphology in a multihospital collaborative extracorporeal membrane oxygenation project. Am J Pathol 1979; 95:191–214.
Bitterman PD. Pathogenesis of fibrosis in acute lung injury. Am J Med 1992; 92(Suppl 6A). 6A-39S.
Meduri GU, Blenchia JM, Estes RJ, Wunderink RG, Torky ME. Leeper KV. Fibroproliferative phase of ARDS. Clinical findings and effects of corticosteroids. Chest 1991; 100:943–952.
Crouch E. Pathobiology of pulmonary fibrosis. Am Physiol Soc 1990; 259:L159-L184.
Polunosvsky VA, Chen B, Henke D, Snover D, Wendt C, Ingbar DH, Bitterman PB. Role of mesenchymal cell death in lung remodeling after injury. J Clin Invest 1993; 92:388–397.
Elliott CG. Pulmonary sequelae in survivors of the adult respiratory distress syndrome. Clin Chest Med 1990; 11:789–800.
Adamson, IY, Bowden DH. The type II cell as progenitor of alveolar epithelial regeneration: a cytodynamic study in mice after exposure to oxygen. Lab Invest 1974; 30:35–42.
Matalon S. Mechanisms and regulation of ion transport in adult mammalian alveolar type II pneumocytes. Am J Physiol 1991; 261:0727–738.
Matthay MA, Folkesson HG, Verkmanas. Salt and water distal airway epi-thelia in the adult lung. Am J Physiol (Lung Cell Mol Physiol) 1996; 270:L487-L503.
Panos R, Rubin JS, Csaky KG, Aaronson SA, Mason RJ. Keratinoctye growth factor and hepatocyte growth factor are heparin binding growth factors for alveolar type II cells in bibro-blast-conditioned medium. J Clin Invest 1993; 92:967–977.
Henke C, Piegel V, Peterson M, Wick D, Knighton J, McCarthy J, Bitterman P. Identification and partial characterization of angiogenesis bioactivity in the lower respiratory tract after acute lung injury. J Clin Invest 1991; 88:1386–1395.
Bone RC, Maunder R, Slounan G, et al. An early test of survival in patients with the adult respiratory distress syndrome. The Pa02/FI02 ratio and its differential response to conventional therapy. Chest 1989; 96:849–51.
Chesnutt A, Matthay MA, Clark JC. Type III precollagen peptide is present in pulmonary edema fluid on day one of patients with acute respiratory distress syndrome. Am J Resp Crit Care Med 1996; 153:A11.
Doyle IR, Nicholas TE, Bersten AD, Serum surfactant protein A levels in patients with acute cardiogenic pulmonary edema and the adult respiratory distress syndrome. Am J Repir Crit Care Med 1995; 152:307–317.
Rubin DB, Wiener-Kronish PJ, Murray JF, Green DR, Turner J, Luce JM, Montgomery AB, Marks JD and Matthay MA. Elevated von Willebrand factor antigen in an early plasma predictor of acute lung injury in nonpulmonary sepsis syndrome. J Clin Invest 1990; 86:474–480.
Montgomery AB, Stager MA, Carrico CJ, Hudson LD. Causes of mortality in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 1985; 132:485–489.
Doyle R, Szaflarski N, Modin GW, Weever-Krnish JP, Matthay MA. Identification of patients with acute lung injury i predictors of mortality. Am J Respir Crit Care Med 1995; 152:1818–1824.
Pittet JF, Wiener-Kronish JP, McElroy M, Folkesson HG, Matthay MA. Stimulation of lung liquid clearance by endogenous catecholamines in septic shock. J Clin Invest 1994; 94:663–671.
Pittet JF, Matthay MA, Pier G, Grady M, and Wiener-Kronish JP. Pseudomo-nas aeruginosa-induced lung and pleural injury in sheep. J Clin Invest 1993; 92:1221–1228.
Villar J, Slutsky AS. The incidence of the adult respiratory distress syndrome. Am Rev Respir Dis 1989; 140:814–816.
Lewandowski K, Metz J, Dentschmann C, Preib H, Kuhlen R, Artigas A, Falke KJ. Incidence, severity and mortality at acute respiratory failure in Berlin, Germany. Am J Respir Crit Care Med 1995; 151:1121–1125.
Morel DR, Dargent F, Bachmann M, Suter PM, Junod AF: Pulmonary extraction of serotonin and propranolol in patients with adult respiratory distress syndrome. Am Rev Respir Dis 1985; 132:479–484.
Artigas A, Lemeshow S, Rue M, Avrunin J, Le Gall JR. Risk stratification and outcome assessment of patients with acute lung injury. Am J Respir Crit Care Med 1994; 149:A1029.
Knaus WA, Hakim RB, Wagner DP. Evaluations of definitions for adult respiratory distress syndrome. Am J Respir Crit Care Med 1994; 150:311–317.
Author information
Consortia
Additional information
This conference report is being simultaneously published by Intensive Care Medicine and the American Journal of Respiratory and Critical Care Medicine. Copyright is shared by the American Journal of Respiratory and Critical Care Medicine and by Intensive Care Medicine. Inquiries about reprints should be directed to the American Journal of Respiratory and Critical Care Medicine or to the European Society of Intensive Care Medicine (40 Av Joseph Wybran, B-1070 Brussels, Belgium).
Rights and permissions
About this article
Cite this article
Artigas, A., Bernard, G.R., Carlet, J. et al. The American-European consensus conference on ARDS, Part 2. Intensive Care Med 24, 378–398 (1998). https://doi.org/10.1007/s001340050585
Issue Date:
DOI: https://doi.org/10.1007/s001340050585